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Green Cleaning Study Shows Breadth of Green Cleaning Programs in Hospitals, Need for Health Outcomes Research

WASHINGTON, D.C.– A new research report released by the Health Care Research Collaborative points out the need for studies to determine the impact of green cleaning programs on health outcomes in patients and staff, and for additional studies to determine the impact of green cleaners on environmental cleanliness and hospital-acquired infection transmission. The report, “Green Cleaning in Healthcare: Current Practices and Questions for Future Research,” noted that studies need to address a number of topics to help healthcare facilities choose an effective green cleaning program.

“This report indicates that in their efforts to implement green cleaning programs, most hospitals do not have the research available to them in order to determine the best cleaners for their programs, nor do they have sufficient guidance to determine which of the green cleaners are proven to be most effective in the health care setting,” said Xiaobo Quan, Ph.D., EDAC, of The Center for Health Design.  “We also found that we need additional information about green alternative cleaners—such as their impact on staff illness and reaction to the cleaners.”

For the report, authors Quan; Anjali Joseph, Ph.D., EDAC; and Matthew Jelen, all from The Center for Health Design, conducted a literature review and five case studies, and analyzed 150 responses to an online hospital survey conducted by the Healthier Hospitals Initiative Pebble Project, which was initiated to promote and support development of green cleaning initiatives by better understanding current green cleaning practices and identifying future research topics of high priority.

The authors found that variations exist in green cleaning practices across different facilities. The selection of cleaning products that contain or use less harsh chemicals is the most commonly adopted method. Almost all case study facilities conducted initial evaluation of new products and procedures before implementation, but rarely monitored or evaluated the performance of the products and procedures after adoption.

“We need to provide more information–for example, what constitutes a green cleaning program for a healthcare facility,” stated Dr. Joseph. “Further, there is no clear evidence indicating whether cleaners that are promoted as ‘green clean­ers’ effectively meet infection prevention needs and standards given the current focus on the environmen­tal contribution to HAIs or whether such cleaners have unknown health risks.  There is an urgent need to conduct research around cleaning in healthcare.”

Hospitals participating in the case studies were Dartmouth-Hitchcock Medical Center, Lebanon, N.H.; Ridgeview Medical Center, Waconia, Minn.; Magee-Women’s Hospital of UPMC, Pittsburgh, Pa.; Boulder Community Hospital, Boulder, Colo.; and Cleveland Clinic, Cleveland, Ohio.  All of these hospitals are award winners and active members of Practice Greenhealth.  The report was conducted as part of the Pebble Project. 

The Research Collaborative was initiated by Health Care Without Harm (HCWH), an international nonprofit coalition that promotes environmental responsibility in health care, and is coordi­nated by faculty of the University of Illinois at Chicago School of Public Health, with support from the Pioneer Portfolio of the Robert Wood Johnson Foundation.  The Collaborative also interacts closely with the Healthier Hospitals Initiative (HHI), a group of health systems that are leading the way in implementing green practices in healthcare.  This paper is the ninth in a series of papers in which the Collaborative provides research and analysis of factors influencing patient, worker and environmental safety and sustainability in the healthcare sector. The editors of this series are Peter Orris, M.D., MPH and Susan Kaplan, JD.

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Posted November 2, 2011

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